Assessment

Risk Factors for Coronary Artery Disease

Coronary Heart Disease is a condition which arises when the coronary arteries get blocked with plaque. The plaque gradually increases in size making the arteries narrow. This is known as atherosclerosis. It can affect children and advances as one grows.

With the arteries getting clogged, less blood reaches the heart hence chains pains. This may result to heart attack. It leads as the number one cause of death in Australia: close to 21,700 Australians died due to this in 2010.

Risk factors that lead to Coronary Heart Disease include: smoking, high cholesterol, high blood pressure, diabetes, lack of exercise, obese and socially-inactive (Bång, et al, 2008). These risk factors can be managed. There are other risk factors that cannot be controlled; age, male and family history.

Smoking impacts the amount of blood the heart and other parts of the body gets. It limits the oxygen flow and destroys the arteries (Rimm et al, 1998). This may lead to heart attack, stroke and arterial infection.

Cholesterol is fat produced by the body. Coronary Heart Disease if it rises above required levels to block the arteries hence limiting blood flow (Knekt, et al, 1997). It arises from food content rich in cholesterol otherwise called, low-density lipoprotein.

Blood pressure is another factor resulting from high pressure as the blood flows in the body. This depends on the amount of blood pumped and ease of flow (DH, et al, 2005; Lloyd-Jones et al (2009). Its level is affected by what the person undertakes. This may arise due to family history, eating trends, alcohol, weight and physical activity.

Diabetes results from high or low sugar content in the body. Most of the patients suffering from Coronary Heart Disease suffer from type 2 diabetes. One has to manage their physical activities, eat a balanced diet and keep watch of their weight.

Glycerol Trinitrate (GTN) Medication

Glycerol Trinitrate are tablets or spray used to help the heart to undertake its functions effectively. It operates through changing itself in the body to a chemical known as nitric oxide. The body produces it and has the ability of increasing the size of the veins and arteries. This leads to more space and limited pressure to flow (Stoney et al, 1999). Hence, the heart pumps the blood easily to the other parts of the body.

Similarly, increasing the size of the veins lowers the volume of blood which goes back to the heart after every pump (Guyton, 1998). This enables the heart to pump easily. Additionally, the arteries improve the supply of blood and oxygen to other parts of the body.

The pain on the chest arises due to little oxygen getting to the heart as the heart beat rises, cases like when exercising. Glycerol Trinitrate enables more oxygen to flow to the heart and limits the oxygen that the heart requires by enabling it to pump to all parts of the body (Jager et al, 1999; Kruse, et al, 1998).

The medication has to be taken through the mouth and allowed to dissolve while in the mouth. This can be attributed to the large number of blood vessels it comprises which speeds the rate at which the tablet dissolves. The patient will feel a sense of relief from the pain (Hertog et al, 1995; Rajendran et al, 2006). The tablets help to prevent any attack to the heart resulting from blood flow. For instance, when exercising, being in stressful situations or in low temperature environment. Recommendation for the patients is to avoid alcohol as has varied negative implications. Moreover, the tablets have to dissolve and not swallowed.

Diagnosis of STEMI using 12 lead ECG

The 12-lead ECG acts as a strong element in the early diagnosis of STEMI. The diagnosis of STEMI relies on STE of about 1 to 2 mm which occurs in about 2 anatomically based ECG leads. This shiws the availability of STE as the absence of STEMI leads to STE.

With the presence of STE, next is to know if the diagnosis is STEMI. This looks to find the LVH through voltage trend. In case QRS complexes are bigger than the sizes seen, then there is a probability that LVH is available (Elwood et al 2002; Ornish et al, 1998). On the other hand, if the QRS are of average size, then there is a probability that the LVH may not be available. Hence the STE does not arise from LVH-based repolarization and cancelling the main cause of non-STEMI ST-segment with regard to ECG.

The next part we look at its width. In the case that QRS is bigger than the required width then bundle branch block (BBB) and ventricular paced trends are probable (Huonker et al, 1998). This includes STEs. On the other hand, if the QRS is of normal width, then the STE does not arise from BBB or ventricular-paced trends. We cancel non-STEMI causes of STE.

Lastly, focus goes to ST-segment depression that takes place on the ECG. Here several causes of non-STEMI are not included. Here consideration does to BER, acute pericarditis and left ventricular aneurysm (Brady et al, 2001). The presence of reciprocal ST-segment determines the availability of ECG diagnosis of STEMI. Consideration should be given that not all presence shows this. It has to be used early on for the interpretation of ECG and the STEMI will diagnose in ED.

 

 

 

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